The different types of compression bandages available

There are a plethora of bandages and bandage systems available in the management of Venous Leg Ulcers, few of which have been robustly compared in randomised controlled trials (RCTs).

Long-Stretch Bandages (LSB)

A long-stretch bandage can be stretched by over 100% and has the ability to return to its original size.

A long-stretch bandage maintains a constant pressure by continuously tightening the calf muscle whether the patient is at rest or walking. Used alone , these elastic bandages have the drawback to maintain a constant high pressure at rest, which can be difficult for the patient to tolerate⁽¹⁾ and impacts patient adherence to the treatment.

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Short-Stretch Bandages (SSB)

A Short-stretch bandage has no or minimal stretch. It maintains a semi-rigid cylinder that does not yield when the calf muscle expands and relaxes during activity.

A short-stretch bandage exerts a low pressure when the patient is at rest but a high pressure during exercise. While walking, the calf muscle is firmly maintained by the bandage with a massage effect, thus reinforcing venous return. A common drawback with a short-stretch bandage system is that if your patient has a weak or ineffective calf muscle, or is immobile for long periods of time, the short-stretch bandage will fail to generate adequate levels of compression⁽²⁾. Used alone, the short-stretch bandage tends to quickly lose pressure and slip⁽³⁾.

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Multi-Component bandages (MCB)

A multi-component bandage system can be defined as a compression system made up of more than one element of compression materials, that are applied one over the other (i.e. short stretch and long stretch together in the same system). This system combines the advantages of the two bandages and guarantees a continuous, consistent and comfortable compression system, whatever the patient’s activity or mobility status.

Multi-component bandages provide a massage effect during exercise and maintain therapeutic pressure at rest.

The system stays in place and maintains pressure and stiffness over time. It can be worn day and night improving patient adherence to the treatment.

Multi-component bandages are recommended by the EWMA guidelines as a more effective compression treatment than single component bandages in achieving Venous Leg Ulcer healing⁽⁴⁾. This is also supported by the Cochrane review who summarises that multi-component bandages are more effective than single-component systems and that multi-component bandages containing an elastic bandage appear to be more effective than those composed mainly of inelastic constituents⁽⁵⁾.

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DID YOU KNOW? Recurrence rate of VLU

The recurrence rate of a VLU within 3 months after wound closure is as high as 7. This is why in patients with a healed VLU, compression therapy is recommended, to decrease the risk of ulcer recurrence⁽⁶⁾

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1. ‍QIPI Community nurses France 2016. Usage of compressionbandages. Surveyof Community nurses ; June 2016. 75 respondents. 136 patients‍
2. JüngerM, Ladwig A, Bohbot S, et al. Comparison of interface pressures of threecompression bandaging systems used on healthy volunteers. J Wound Care. 2009;18(11):474, 476-80
3. Parstch  M. Understanding Compression Therapy: EWMAPosition Document. Medical Education Partnership Ltd; 2003. Understanding thepathophysiological effects of compression; pp. 2–5.;
4.  Franks, P., Barker, J., Collier, M. et al.Management of patients with venous leg ulcer: challenges and current bestpractice, J Wound Care, 25; 6, Suppl, 1–67
5. 2021The Authors. Cochrane Database of Systematic Reviews published by John Wiley& Sons, Ltd. on behalf of The Cochrane Collaboration.
6. Management of patients with venous leg ulcers:Challenges and current best practice. Journal of Wound Care, vol 25 no 6. EWMAdocument 2016.

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